Role of the social worker in the outbreak of pandemics (A case of COVID-19)

Abstract Social work practice is a helping profession that adopts skills and theories of human behavioral and social systems in resolving social problems. The Corona Virus Disease (COVID-19) as a pandemic have ravaged the world causing millions of infections and close to two million deaths globally. This article has the objective of exploring the role of social workers in the outbreak of a pandemic thereby preparing the social work profession for future outbreaks. The social work profession plays huge roles in providing awareness, psychosocial support, and advocating for social inclusion for the most vulnerable population. Also design and implementation of interventions that will positively impact the lives of the vulnerable population and the society at large are the hallmark of social work profession.


Introduction
A social worker is a professional who focuses on enhancing the overall well-being of the general population, assisting to meet the basic and complex needs of individuals and/or communities, prioritizing the vulnerable, oppressed, and those living in poverty. They contribute greatly to the care, support, promotion of rights, as well as empowerment of vulnerable populations (Bess & Collins, 2014).

Afomachukwu Okafor
ABOUT THE AUTHOR Afomachukwu E. Okafor completed his First Degree in Economics, Master's Degree in International Corporation and Humanitarian Aid, A Masters Degree in Monitoring and Evaluation, and Currently a Doctoral Candidate for a Ph.D in Social Works. He has worked with multiple International Non Governmental Organizations and the United Nations Agency as a Monitoring and Evaluation Professional having over 6 years of experience in the design and implementation of monitoring and evaluation strategies for humanitarian (multi-sectoral) and development projects cutting across HIV/AIDS, TB, Reproductive Health, WASH, Nutrition, Food Security and Livelihood, Agriculture and Education. He has conducted as well as contributed to various project evaluations and research activities and is currently conducting various researches in the areas of Social work and integrated public health care models.

PUBLIC INTEREST STATEMENT
In a world of emerging global humanitarian emergencies and pandemics such as COVID-19 which has ravaged the world with millions of infections and deaths, the researcher has explored the roles social workers play in the outbreak of a pandemic. These roles include the creation of awareness on the pandemic, provision of psychosocial support, advocating for social inclusion for the most vulnerable population and the design and implementation of interventions that will positively impact the lives of the vulnerable population among many others. This paper triggers reflection as well as serve as a wake up call to the social work profession and policy makers to better prepare for outbreak of pandemics.
The social work practice as a helping profession adopts the use of skills and theories of human behavioral and social systems in alleviating and resolving social problems that affects individuals, groups or communities. The role of social workers encompasses different dimension of social issues, among which is the COVID-19 pandemic.
COVID-19 have ravaged the world with over 81 million confirmed positive cases and more than 1.7 million deaths globally as at December 2020. Apart from its deadly nature, COVID-19 has caused damaging impact to the psychological and social wellbeing of society's underserved populations which includes but not limited to the poor, aged, children, people with disabilities, etc. (Amadasun, 2020a). Also, COVID-19 greatly impacted negatively on the economy of many nations, across education, health, agriculture, information technology, energy, oil and gas, and an array of other sectors.
In a world of emerging global humanitarian emergencies and pandemics such as COVID-19, Cooper and Briggs (2014) noted that the educational training received by social workers does not in all sufficiency, prepare them for specific roles in the outbreak of a pandemic. Hence, this paper becomes relevant in outlining to enhance the roles of social workers in the face of an outbreak of a pandemic.

Corona virus: The pandemic
The Corona Virus Disease named COVID-19 (World Health Organization (WHO), 2020a) is a respiratory infectious disease caused by the newly discovered corona virus (World Health Organization (WHO), 2020b), highly transmittable and pathogenic viral infection that is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Shereen et al., 2020). Originating from the Hubei Province of Wuhan, China, the virus has infected over 81 million people worldwide and causing the death of more than 1.7 million people within a short period of time, delivering the world into unchartered waters, turning governments, health workers as well as public health authorities into a quagmire and scrambling to keep up with the outbreak (Weir, 2020). Among the population of the world, the virus has caused huge desperation, social and economic hardship, and hopelessness (Hargreaves et al., 2020).
Although, majority of those infected with COVID-19 experience mild to moderate respiratory illnesses and recovering without any special treatment, older people as well as those with underlying illnesses such as diabetes, cancer, cardiovascular and chronic respiratory diseases are the most at risk to developing serious illnesses (World Health Organization (WHO), 2020a). The spread of COVID-19 is mainly through discharge or droplets from the nose and mouth (saliva) when an infected person coughs or sneezes. This virus is also associated with fever, sore throat, shortness of breath, dry cough, tiredness, and body pain (World Health Organization (WHO), 2020a, 2020c).
There is already a breakthrough in the production of vaccines for COVID-19 and its rollout has commenced globally. The role out of COVID-19 vaccines is challenged by global high demand leading to scarcity; high cost of vaccines; and the sophisticated nature of storage facilities required to sustain the potency of the vaccines before they are administered to individuals. All these leaves many developing countries vulnerable to the impact of COVID-19.
To curtail spread of the virus, regular handwashing using bar soap and water or use of alcoholbased hand sanitizer, maintaining physical distancing, staying at home when one is not feeling well and calling the doctor before hospital visit, use of face masks, covering nose and mouth when coughing or sneezing are recommended (Prem et al., 2020;Rosenthal et al., 2020; World Health Organization (WHO), 2020d).

Social work and COVID-19
The value of social justice is challenged by the grave impact of the COVID-19 pandemic on the powerless groups in the society. Also, in the face of economic and resources deprivation, job losses, and lack of access to healthcare and psychosocial support services, the human dignity suffers.
In view of its involvement in providing wartime relief services as well as concern with physical environment of the people, the social work profession is said to be fully submerged in service during public emergencies (Brinkerhoff, 2014;Hokenstad, 2007;Zakour, 1997). Social workers play fundamental roles in disaster response, recovery and disaster preparedness planning for future occurrences (Cooper & Briggs, 2014). Appropriate and adequate professional social work services are mandatory in the outbreak of emergencies and pandemics (Brinkerhoff, 2014).
The call for the institutionalization of a strapping partnership in response to pandemics and public emergencies between the public and private sectors by Armocida et al., (2020) brings about the urging anticipation for provision of leadership and advocacy by the social work profession for effective services among institutions in response to COVID-19 pandemic. These services must reflect the ethical obligation to protect the general well-being of the society at large (National Association of Social Workers, 2017) paying keen attention and alignment to the social work theory and values, as well as considering the social, cultural, emotional, spiritual and psychological needs of people affected by the pandemic.
As a result of the contagious nature and the non-availability of vaccines and treatment for COVID-19 patients due to its high cost and scarcity, most peoples' perspective about the virus is fear. This leaves psychological trauma on victims and survivors of the virus, leaving social workers and medical professionals overwhelmed by a lot of work to be done. Tam et al. (2004) noted that when compared to the general population, medical care workers are more likely to experience a wide range of negative psychological impact following the outbreak of an emergency or disaster. Other studies also noted that during and after the outbreak of infectious diseases such as Severe Acute Respiratory Syndrome (SARS), Ebola and Middle East Respiratory Syndrome (MERS), there were reported cases of emotional stress among medical care workers (Lee et al., 2018;Raven et al., 2018). The case is not different in the face of COVID-19 as there has been increased global report of emotional and psychological stress amongst the health care providers. Si et al. (2020) reported a 40.2% positive screen for significant post traumatic syndrome disorder symptoms among health care workers while noting a higher proportion of having mild to extreme severe symptoms of stress, anxiety and depression.
Quarantine and physical distancing measures are being deployed globally, baring family members from attending to their affected, dying or dead loved ones. With this in place, it becomes difficult for families to see their loved ones on their sick bed, as well as bury their loved ones according to their customs and traditions in the case of death. These scenarios bring about disturbing images and remains one of the visible challenges for which the social work profession must prepare for (Rosoff, 2008).
The increased demand for trained social work and mental health professionals is necessitated by the disaster-prone and fast-changing world, and it is envisaged that future pandemics will bring with them, unthinkable levels of psychological trauma. With this in mind, Brinkerhoff (2014) noted that social work institutions are to increase investment in the education of students and practitioners of social work, in the areas of trauma response and specialized methods of critical incidence stress debriefing. This will effectively help prepare the social work profession for pandemics and disasters, while enhancing efficiency and responsiveness in disaster relief and various efforts that are geared towards providing stress management, as well as social and mental health services to survivors of a pandemic. In doing all these, attention should be paid to support needs of the victims and survivors.

The social workers' role during pandemic
The Social work profession provides unique services to the people during disaster, pandemic and other public emergencies. Social workers play fundamental roles in disaster response, recovery and disaster preparedness planning for future occurrences (Cooper & Briggs, 2014) and appropriate professional social work services are to be mandatory in the outbreak of emergencies and pandemics (Brinkerhoff, 2014). Despite the huge number of confirmed infections and deaths attributed to the COVID-19 pandemic, there are millions of people around the world reported to have recovered from it, and there is no doubt that many of the survivors will require as well as find their way in palliative and/or non-curative care services. In this situation, social workers are to provide the best and most compassionate care that can possibly be provided which also includes adequate planning (Rosoff, 2008).
In the face of racial, gender, and ethnic discrimination being experienced by marginalized groups globally, the COVID-19 pandemic globally and especially in developing countries comes with a high degree of stigma and discrimination especially on the survivors and infected persons. In this regard, comes the extraordinary roles of social workers to serve and protect the most vulnerable during a pandemic such as COVID-19. (Amadasun, 2020a:2) noted that "responding to social problems emanating from public social and healthcare challenges is the raison d'etre of the social work profession and addressing COVID-19 in terms of its grievous fallout on social conditions as a whole and in the lives of individuals, families and households, groups, and communities in specific is a professional imperative". A variety of mental health supporting strategies are required in pandemic areas to facilitate the lifestyle changes and re-adaptation activities required after the occurrence of outbreaks Xiang et al., 2020), and this falls within the purview of the social work profession to provide.
The goal of social work profession is to advance social cohesion and stability, promote social change development through empowerment and liberation of people as well as restoring social functioning while championing respect for the sanctity of life and drawing on the ideals of social justice and human dignity (Amadasun, 2020b). Considering this, social workers have the responsibility of playing crucial and frontline role of helping and supporting communities that are affected by COVID-19. Responsibilities of social workers are not limited to the fight against the spread of COVID-19, ensuring inclusion of the most vulnerable in planning and response, organizing communities in ensuring the availability of essential items like food and clean water, advocating for social inclusion of the most vulnerable into the social service system, as well as facilitating physical distancing and social solidarity through campaigns and orientation programs (International Federation of Social Works (IFSW), 2020). Social workers must recognize that stigma fuels the isolation of people and blocks access to care and support which in turn contributes to the continued spread of disease. With this, social workers must step on to the role of creating awareness as well as combating myths about the pandemic, fear and stigma in intense environments.
The social work role given the delirious invasion of pandemics on families and individuals is within the healthcare systems as well as within poor households having inadequate or no medical health insurance and/or lacking the knowledge on how to secure one. In light of this, the social workers' role must be that of a counsellor, educator and referral linkage to the health care facilities. Given that individuals and families find comfort in a variety of certain factors, the social workers' interventions in these roles are to be channeled to strength-based practices, relationship building strategies and resilience coupled with a blend of spirituality. Older persons are the most at risk group for COVID-19. Maintaining physical distancing has limited social workers' interaction and care for the older people. Social workers are to explore leveraging on and promoting kinship care and support practices as an alternative mechanism to meeting the welfare of older people (Cudjoe & Abdullah, 2020). In the case of death of parents or guardians in a pandemic, social workers are to provide safe spaces for children or minors ensuring that they get proper shelter, health care and nutrition. This will eradicate or reduce the psychological trauma that the children might experience because of lack of parental care, stigma, or rejection by other family members for fear of contamination.
Social workers' role includes advocating for social inclusion of the most vulnerable into the social policy service system in the face of a pandemic. Given that the response platforms are provided by and within organizations while communities are at the receiving end, the engagement in social inclusion advocacy becomes paramount to ensuring social protection for the vulnerable or marginalized members of the society. In doing this, advocacy could be done on different policy response levels depending on its appropriateness for the prevailing conditions. This could be for short-term policy actions such as cash transfers or distribution of in-kind items such as food, etc. to the most economically disadvantaged households. On the other hand, the advocacy could be for long-term policy options which mostly will revolve around provision of affordable healthcare plan for the most vulnerable population, investment in health and social care facility infrastructures, affordable housing, etc. The International Federation of Social Works (IFSW), 2020 noted that as a profession, the social workers' responsibility is the advocacy for health and social service system strengthening and advancement, which are very important in protecting people against the virus, curbing inequalities and reducing social and economic challenges of the society. Also, social workers must play a key role in the mobilization of communities, organizations/groups and facilitating connections between the systems of care set up by government and the community-based systems such as the community/ district social welfare workers, child protection officers and community development officers.
There has been in the past, different levels of unverified messages that has been passed through different media platforms most especially the social media in the period of outbreaks such as COVID-19, EBOLA, SARS, etc, majority of them are misleading and could cause more harm to the ignorant population. Effective communication, orientation and educating the public on the pandemic is a very important role that must be played by social workers in the light of this development. This is to keep the society well informed about the true state of affairs as regards the pandemic as well as avoid social disruptions caused by fear, rumors or neglect by appropriate authorities.
Emphasis is made on the importance of carrying out these roles in line with the professional values of social work practice which includes service, human rights, integrity, social justice, human dignity, confidentiality, and human relationships. Also, most especially in communication during the outbreak of a pandemic such as COVID-19, '"messages are to be built around hope, resilience and the resolve of human spirit to surmount any impediments' (Amadasun, 2020b).

Conclusion
The social work profession is well equipped with great values and historical legacies and social workers are in a unique position to address emerging public health disease outbreaks such as COVID-19.
Notwithstanding that the social workers' role in management of outbreak/emergencies are neglected in the curriculum of social work education, the application of required skills in the outbreak of a pandemic goes a long way in positively impacting the lives of vulnerable population as well as the society at large.
In responding to the COVID-19 pandemic, social workers have huge roles to play as it requires critical awareness from the social work profession. This includes the provision of adequate social support for the general population with regard to specific at-risk populations such as the infected patients, quarantined individuals, medical professionals, etc.; advocacy for social inclusion for the most vulnerable, creation of awareness on the pandemic, implementation of mental health supporting strategies and community-based strategies to support resilience and psychologically vulnerable individuals and groups during the COVID-19 pandemic. Also, the psychological impact of fear and anxiety induced by the rapid spread of the COVID-19 pandemic needs to be clearly recognized as a public health priority for both social workers, authorities and policy makers and clear behavioral strategies to reduce the burden of disease and the dramatic mental health consequences of this outbreak is to be rapidly adopted and implemented (Serafini et al., 2020).
This presents the social work profession a great opportunity to really set the center stage for further interventions, present itself in a unique position to addressing issues, as well as imprint indelible marks in the hearts of victims and survivors of emergencies and pandemics such as COVID-19.